Increasing uptake of childhood influenza vaccination: results of two cluster randomised controlled trials (cRCTs) of behavioural science informed changes to invitations
PHE ePoster Library. Howell-Jones R. 09/13/17; 186453; 207
Dr. Rebecca Howell-Jones
Dr. Rebecca Howell-Jones
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Abstract
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Abstract ObjectiveTo investigate the impact of behavioural-insight informed invitation letters on childhood influenza vaccine uptake and consent form return. Methods Schools cRCT: 2x2 factorial design comparing i) intervention letter to control (letter used in previous year) and ii) request for a reminder message to control (no request). GPs cRCT: comparison of centrally-sent intervention invitation letter with no centralised letter. Letters were sent using the Child Health Information System (CHIS) to 2 and 3 years olds. Results Schools: 1,358 schools were randomised. Data were analysed on 1,208 schools with Years 1-3 (from four providers covering 11 local authorities). Crude uptake in those receiving the intervention letter with reminder was 62.3% and without reminder 60.8%; control letter with reminder was 61.7% and without reminder 60.5%. After controlling, for example for age, the adjusted odds ratio (aOR) of vaccine uptake for the intervention letter was 1.03 (95%CI 0.97-1.08) and 1.06 (1.00-1.15) for the reminder request. For return of consent forms, the intervention letter aOR was 1.08 (1.00-1.17) and reminder request 1.09 (1.00-1.17). GPs: 257 practices from 7 CCGs were randomised. Data were available on 250 practices. CHIS recorded uptake in practices with data systems which automatically update CHIS was 44.2% in the intervention arm and 28.9% in control. In non-linked practices, crude uptake was 21.7% and 12.0% respectively. Conclusion The schools trial showed that modifying the communication had a small but not statistically significant impact on uptake. The GP trial provides further evidence of the benefit on immunisation uptake of sending invitation letters.
Abstract ObjectiveTo investigate the impact of behavioural-insight informed invitation letters on childhood influenza vaccine uptake and consent form return. Methods Schools cRCT: 2x2 factorial design comparing i) intervention letter to control (letter used in previous year) and ii) request for a reminder message to control (no request). GPs cRCT: comparison of centrally-sent intervention invitation letter with no centralised letter. Letters were sent using the Child Health Information System (CHIS) to 2 and 3 years olds. Results Schools: 1,358 schools were randomised. Data were analysed on 1,208 schools with Years 1-3 (from four providers covering 11 local authorities). Crude uptake in those receiving the intervention letter with reminder was 62.3% and without reminder 60.8%; control letter with reminder was 61.7% and without reminder 60.5%. After controlling, for example for age, the adjusted odds ratio (aOR) of vaccine uptake for the intervention letter was 1.03 (95%CI 0.97-1.08) and 1.06 (1.00-1.15) for the reminder request. For return of consent forms, the intervention letter aOR was 1.08 (1.00-1.17) and reminder request 1.09 (1.00-1.17). GPs: 257 practices from 7 CCGs were randomised. Data were available on 250 practices. CHIS recorded uptake in practices with data systems which automatically update CHIS was 44.2% in the intervention arm and 28.9% in control. In non-linked practices, crude uptake was 21.7% and 12.0% respectively. Conclusion The schools trial showed that modifying the communication had a small but not statistically significant impact on uptake. The GP trial provides further evidence of the benefit on immunisation uptake of sending invitation letters.
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